Would you do it over again?

[UnicornDemon]

Knowing what you know now, if given the option to go back all the way to undergrad, would you choose again to pursue medical school? And, if so, would you re-select cardiology as your specialty?

If no, what would you have done differently?

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[josephf1]

very practical question
in last yr of cardio fellowship so been a this for a while
would base answer on
1) other things a person could have done in their life
2) graduation debt:income ratio
3) ego

as for 1), i previously was in bizness and made 80K a year. Now graduating cardiology ill make 3-4 times as much. but keep in mind i lost out on 10 years of income, lifestyle, and would be drowning in debt had my parents and in laws not helped me out the last 9 years
lots of easier money in real estate, law, mba, dentistry, internet development, etc. may be better to be PA to some degree as well
as for 2) if you are graduating with 300K+ and will have to pay back 3K/month for years, than that will eat up 1/3 of your after tax income, you will be left with maybe 6-7 K a month, thats nothing, a nice house alone will cost that
3) ego comes in all shapes and sizes, not sure how much cache a DO or carib degree even has, as it shuts out the big $$$ fellowships. in my recent experience saying im a doctor' evokes more pity than awe.
in conclusion for me it worked out, but i had financial backing throughout my training from family to limit debt and now i will earn more than i did before by alot and overall i am a simple guy so could handle living low the last 10 years, but in retrospect cardiology is dying fast, as proof of being flooded with IMGs, the offers in the nice cities are simply on par with hospitalist, I wanted to do EP and there are no jobs so I bailed on that, and if I had to do it all over again I would have done orthodontics.

 

[EPADHA]

Knowing what you know now, if given the option to go back all the way to undergrad, would you choose again to pursue medical school? And, if so, would you re-select cardiology as your specialty?

If no, what would you have done differently?

No. It is a great specialty, but the rewards are not worth it. I dont know if I am jaded by my fellowship program, or if it's the specialty in general.
I am an invasive non-interventional cardiologist: we are like a dodo; very few jobs..
I may do dermatology or rheum+allergy , if I could do it all over again.

 

[supp-2]

In a heartbeat personally!

1) Income: To me job security is the most important thing. Unless I do something criminal, I'm guaranteed to make 300k+ for the next 30 years. Even if the yit hits the fan, I will always make 6 figures until I die. I'll give up some extra spending money in my twenties for that. I'll never worry about losing my job suddenly and not being able to pay my mortgage or my kid's college. To me that is worth A LOT.. more so that getting equity in a house when I'm 27.

2) People in medicine and on the message boards are a little too flippant about how easy it is to make money in other fields. I make 130-150k a year in my young 30s as a moonlighting fellow. I'll be making 300-600k a year in mid thirties and beyond. I have a lot of smart friends and not too many are making more than I make now or even less or none will be making more than I will be making in a year or two (and these are Ivy grads, ect). Sure opportunity costs, student debt, ect hurt a little but in 5 years time with making a half-million a year I should make up for that. I do agree the very, very top end guys in other fields make what I'll never see and I have an I-banking friend making more than I'll ever see but they can also lose that at any time and have to start from scratch. They also have a lot more stressful job in my opinion and bottom line many have died by the wayside for a few of those guys to get to the top.

3) Just sat down with my financial advisor and went over some planning based on income from where I'll likely sign. By the time I'm 40 (after 5 years in practice) I plan on having a million dollar home, a 500k vacation home, a porsche, a boat, a country club membership with an annual guaranteed salary of 300-500k a year in a city that I would chose as the #1 place that I would want to live in the country (lucky for me, I'm not a big-city guy). I moonlighted a lot during fellowship, went to a state school for med school and only have about 80k in student loan debt, ect so my case might not be like everyone in Cards. But, again, not too many 40 years olds in other fields can have that.

4) People might disagree with me and it might change when full fledge attd, but I don't think our job is as stressful as some of my friends. I never have a "huge powerpoint presentation on a new advertising campaign" or need to raise funds or hit my quarterly sales numbers. I don't lose hair if the markets tank. As long as I don't do something criminal or treat people poorly, I will never get fired. To me, I show up at work in the morning do my best to provide good patient care, treat people nicely and I'm fine. I don't have a personality that gets too overworked and I think that is important in medicine esp in a field like Cards. Again, even the sickest of sick patients don't "stress me out" though does take devoted time, ect.. Being pulled in multiple directions would be the main difficult thing but I haven't experienced that too much yet.. Obviously may change.

5) I don't get as much satisfaction out of patient interactions that I thought I would starting out but I don't mind it. Overall, I just like being in a job where I don't have to be dishonest to make money (like some businessman, lawyers). I just appreciate not being in a confrontational profession like that.

6) Cardiology to me is physiologically interesting, has more interactions with industry that I think is beneficial (even if that is changing with time), has a fair amount of innovation and money being pumped in by industry, is one of the highest on the totum pole (not getting dumped on, questioned, ect like other specialties. I think I could have done Ortho or a sub-surgery type, but overall not disappointed with my selection. Never in a million years could I do GI or oupt work or even Hospitalist work other than for a few years.. Heme/Onc would be fine but not super exciting in my eyes.

CONS:

1) Nights are bad. If able to be in a specialty that doesn't do nights that that would be a major bonus. Call is the only thing that I really, really don't like about this profession.

2) Cutting reimbursements.. Obviously shift is towards hospital employment. Important IMO going forward that Cardiologist work together and create favorable practice set ups to counter that..

 

[infarct]

In a heartbeat personally!

1) Income: To me job security is the most important thing. Unless I do something criminal, I'm guaranteed to make 300k+ for the next 30 years. Even if the yit hits the fan, I will always make 6 figures until I die. I'll give up some extra spending money in my twenties for that. I'll never worry about losing my job suddenly and not being able to pay my mortgage or my kid's college. To me that is worth A LOT.. more so that getting equity in a house when I'm 27.

2) People in medicine and on the message boards are a little too flippant about how easy it is to make money in other fields. I make 130-150k a year in my young 30s as a moonlighting fellow. I'll be making 300-600k a year in mid thirties and beyond. I have a lot of smart friends and not too many are making more than I make now or even less or none will be making more than I will be making in a year or two (and these are Ivy grads, ect). Sure opportunity costs, student debt, ect hurt a little but in 5 years time with making a half-million a year I should make up for that. I do agree the very, very top end guys in other fields make what I'll never see and I have an I-banking friend making more than I'll ever see but they can also lose that at any time and have to start from scratch. They also have a lot more stressful job in my opinion and bottom line many have died by the wayside for a few of those guys to get to the top.

3) Just sat down with my financial advisor and went over some planning based on income from where I'll likely sign. By the time I'm 40 (after 5 years in practice) I plan on having a million dollar home, a 500k vacation home, a porsche, a boat, a country club membership with an annual guaranteed salary of 300-500k a year in a city that I would chose as the #1 place that I would want to live in the country (lucky for me, I'm not a big-city guy). I moonlighted a lot during fellowship, went to a state school for med school and only have about 80k in student loan debt, ect so my case might not be like everyone in Cards. But, again, not too many 40 years olds in other fields can have that.

4) People might disagree with me and it might change when full fledge attd, but I don't think our job is as stressful as some of my friends. I never have a "huge powerpoint presentation on a new advertising campaign" or need to raise funds or hit my quarterly sales numbers. I don't lose hair if the markets tank. As long as I don't do something criminal or treat people poorly, I will never get fired. To me, I show up at work in the morning do my best to provide good patient care, treat people nicely and I'm fine. I don't have a personality that gets too overworked and I think that is important in medicine esp in a field like Cards. Again, even the sickest of sick patients don't "stress me out" though does take devoted time, ect.. Being pulled in multiple directions would be the main difficult thing but I haven't experienced that too much yet.. Obviously may change.

5) I don't get as much satisfaction out of patient interactions that I thought I would starting out but I don't mind it. Overall, I just like being in a job where I don't have to be dishonest to make money (like some businessman, lawyers). I just appreciate not being in a confrontational profession like that.

6) Cardiology to me is physiologically interesting, has more interactions with industry that I think is beneficial (even if that is changing with time), has a fair amount of innovation and money being pumped in by industry, is one of the highest on the totum pole (not getting dumped on, questioned, ect like other specialties. I think I could have done Ortho or a sub-surgery type, but overall not disappointed with my selection. Never in a million years could I do GI or oupt work or even Hospitalist work other than for a few years.. Heme/Onc would be fine but not super exciting in my eyes.

CONS:

1) Nights are bad. If able to be in a specialty that doesn't do nights that that would be a major bonus. Call is the only thing that I really, really don't like about this profession.

2) Cutting reimbursements.. Obviously shift is towards hospital employment. Important IMO going forward that Cardiologist work together and create favorable practice set ups to counter that..

this...

 

[EPADHA]

this...

thanks very much for forcing me to look at the + aspects of things!!

 

[bronx43]

CONS:

1) Nights are bad. If able to be in a specialty that doesn't do nights that that would be a major bonus. Call is the only thing that I really, really don't like about this profession.

2) Cutting reimbursements.. Obviously shift is towards hospital employment. Important IMO going forward that Cardiologist work together and create favorable practice set ups to counter that..

Most of the pros are more about medicine vs non-medicine, as opposed to cardiology vs non-cardiology. However, I think the cons should be highlighted as they were essentially an afterthought in the above post. If you want to do interventional, the question you have to ask yourself is this - when you're 50, do you want to wake up at 2am every 4-5 nights and drag your ass to the cath lab to put in a stent under radiation? And remember this is 15 straight years of daily radiation exposure. Also, cutting reimbursements are a much bigger problem than one that can be solved by "working together." Dropping reimbursements come from the top, and by that I mean the federal government. Private payers usually follow suit. Cardiologists working together won't stop that tide, especially when supply and demand isn't in your favor. All of a sudden, you'll be doing the aforementioned things for 300k instead of 500k. Are you ready for that? If so, then you'll be happy no matter what happens to the field.

 

[salk]

Most of the pros are more about medicine vs non-medicine, as opposed to cardiology vs non-cardiology. However, I think the cons should be highlighted as they were essentially an afterthought in the above post. If you want to do interventional, the question you have to ask yourself is this - when you're 50, do you want to wake up at 2am every 4-5 nights and drag your ass to the cath lab to put in a stent under radiation? And remember this is 15 straight years of daily radiation exposure. Also, cutting reimbursements are a much bigger problem than one that can be solved by "working together." Dropping reimbursements come from the top, and by that I mean the federal government. Private payers usually follow suit. Cardiologists working together won't stop that tide, especially when supply and demand isn't in your favor. All of a sudden, you'll be doing the aforementioned things for 300k instead of 500k. Are you ready for that? If so, then you'll be happy no matter what happens to the field.

this...

 

[infarct]

this...

solution: become a hospitalist

 

[muzzlenose]

Knowing what you know now, if given the option to go back all the way to undergrad, would you choose again to pursue medical school? And, if so, would you re-select cardiology as your specialty?

If no, what would you have done differently?

I think the answer to that differs from person to person and based on one's own experience. Me personally, there is no question that I would do it all over again. It was rough in internship (I was just before work hour rules), but it made me a much better doctor. While there is always uncertainty in regards to the future of healthcare, there will always be a need for cardiologists and thus I will never be out of a job. From an academic perspective, I feel cardiology gives the best combination of procedures, imaging and actual clinical medicine. I absolutely love practicing cardiology. A cardiologist who does not enjoy what he/she is doing will definitely be miserable.

 

[IMDoc607]

My chief of medicine always said that the field that pays the most today may change. Everyone is crying about how bad cardiology is and how great GI is. Right now radiology and cardio is in the crosshairs of Medicare but that will change. It's only a matter of time till things change for hospitalist and GI. Basically, do what you like and if making 400 is not enough for you then so be it. I just spoke to a graduating fellow first year out is $400 but $200K in loan reimbursements.....not to bad

It beats doing colonoscopies all day. Cardio will always make $$$ because the field is always expanding. You can't say that for many specialties.

 

[justanotherapp]

As a resident, I am tired of being on call. Of not having weekends, and even when I do having to do research to get to the next level. Once you get out of fellowship, what is call cycle like? I do not want 1:4, maybe once every 2-3 weeks. Is this even possible?

Ideally, I would like to work 45-50 hours/week, have time to exercise enjoy time with family, and have 4-6 weeks of vacation a year. Is this possible? I really love cardiology, but working so much during residency has made me resent my choice. Can someone please give me perspective? Should I start thinking about other specialities?

 

[joejabjab]

As a resident, I am tired of being on call. Of not having weekends, and even when I do having to do research to get to the next level. Once you get out of fellowship, what is call cycle like? I do not want 1:4, maybe once every 2-3 weeks. Is this even possible?

Ideally, I would like to work 45-50 hours/week, have time to exercise enjoy time with family, and have 4-6 weeks of vacation a year. Is this possible? I really love cardiology, but working so much during residency has made me resent my choice. Can someone please give me perspective? Should I start thinking about other specialities?

Fellowship has been as difficult if not more difficult than residency for me. But my program is front heavy (third year is much easier than first).

As for the job, I haven't witnessed it as cush as you hope for. . .the call I see are around 1:3 to 1:7

 

[ER BlueBlood]

this...

Lol..you realize that financial advisors are mostly absolute *****s who will tell you what you want to hear. They are the *******es who couldn't achieve a degree worth anything. I think your expectations are way too high but if you can swing it more power to you.

 

[nstemi]

would i go back and be a physician? maybe.

would i go back and choose cardiology? hell yes. every other field is boring.

 

[sacrament]

If I could start ALL over again, I doubt I would choose medicine again. But assuming that I was going to start over again in medicine, I likely would chose cardiology again. The other alternative I would strongly consider would be interventional radiology, except I'm still not sure I could stand the general radiology residency portion.